Analysis of risk factors of metabolic syndrome using a structural equation model: a cohort study

Abstract

Purpose

We aimed to use a structural equation model (SEM) to determine the interrelations between various risk factors, including latent variables, involved in the development of metabolic syndrome(MetS).

Methods

This study used data derived from the MJ Longitudinal Health Check-up Population Database for participants aged 20 to 70 years, who were asymptomatic for MetS at enrollment and were followed up for 5 years. A SEM was applied to investigate the attributions of MetS and the interrelations between different risk factors.

Results

Socioeconomic status (SES), living habits, components of metabolic syndrome (COMetS), and blood pressure had a diverse impact on the onset of MetS, directly and (or) indirectly. When investigating the latent risk factors and the interrelations between different risk factors. The standardized total effect (the sum of the direct and indirect effects, βt) of SES, living habits, blood pressure and COMetS on the onset of MetS was 0.084, −0.179, 0.154, and 0.353, respectively. SES, as a distal risk factor, directly influenced living habits, blood pressure, and COMetS with standardized regression coefficients (βr) of −0.079 (P < 0.001), 0.200 (P < 0.001), and −0.163 (P < 0.001) respectively. Unfavorable living habits exerted an inverse effect on blood pressure and COMetS (βr = −0.101, P < 0.001; βr = −0.463, P < 0.001), which was an important path way for developing MetS.

Conclusions

These results demonstrate that individuals with a higher level of SES are susceptible to high blood pressure and are at increased risk for MetS. Additionally, there is a decrease in exercise and an increase in smoking and consumption of alcohol corresponded to an increase in metabolic risk factors.

Notes

Electronic supplementary material

Acknowledgements

All authors thank MJ Health Management Institution for making their large dataset available to us. We thanks all people participating in the MJ Longitudinal Health study.

Compliance with ethical standards

Ethical approval

The Peking University Institutional Review Board approved this study. Since it eliminated all identifiable personal information, it does not belong to studies involving human beings. Consequently, this Board waived the requirement for informed consent and ethical review of the study. (Authorization Code: MJHRFB2014003C).